Social Accountability and Health: Evidence from Innovative Governance Interventions in Uttar Pradesh

The government of Uttar Pradesh, in collaboration with researchers from Duke, UPenn and World Bank, implemented social accountability (SA) interventions on a large scale in 12 districts in summer 2016. SA interventions aim to provide information to households about rights and responsibilities, and also provide facilitation to enable communities to meet collectively to hold service delivery accountable. We focus attention on 120 villages within 2 of these districts, where the program was implemented as a randomized controlled experiment with two treatment arms (information only in one arm and information plus facilitation in the other arm) and a control arm. Using data from follow up surveys conducted in summer 2018, we estimate impact of the program. The SA interventions led to large significant reductions in rates of stunting and undernutrition, improved rates of full immunization, and also improved health seeking behavior for young children as well as for pregnant mothers. The evidence from this study contributes to emerging evidence on the impact of SA interventions, and also suggests that in settings such as UP, facilitation is a key driver of the success of these interventions.